PMJAY Scheme: Many government hospitals in Jammu and Kashmir are now under strict watch for denying cashless medical care to patients under the Ayushman Bharat PM-JAY SEHAT scheme. After earlier action against private hospitals, the spotlight is now on public hospitals for the same violations.
All You Need to Know
- 11 govt hospitals in J&K have been served show cause notices
- Hospitals include SKIMS Soura, GMC Jammu, SMHS, and others
- Patients were reportedly forced to pay from their pockets despite being eligible for free treatment
- SHA received reports from April 17 to April 30, 2025, confirming violations
- SKIMS Soura tops the list with 14 complaints
- SHA warns of penalties and even suspension if hospitals fail to explain
Why the Action Now?
The State Health Agency (SHA) took this step after getting a detailed report from Paramount Health Services & Insurance TPA Pvt. Ltd. The report found that several patients admitted under the AB-PMJAY and SEHAT scheme were still made to spend money for treatment, which clearly goes against the rules of the scheme.
PMJAY Scheme Scrutiny: Which Hospitals Are Under Scanner?
In Kashmir division:
- SKIMS, Soura (14 cases)
- SMHS, Srinagar (5 cases)
- SKIMS Medical College, Bemina (1 case)
- Super Speciality Hospital, Shereen Bagh (3 cases)
- Children Hospital, Bemina (3 cases)
- JLNM Hospital, Rainawari (2 cases)
In Jammu division:
- GMC Jammu (6 cases)
- Govt Hospital Gandhi Nagar (1 case)
- SMGS Hospital, Jammu (1 case)
- GMC Rajouri (2 cases)
- GMC Udhampur (1 case)
What’s in the Notices?
SHA clearly mentioned that these hospitals have seven days to reply to the notice. If they fail to provide a proper explanation, strict actions will be taken. This could include penalties, de-listing from the scheme, or even legal action.
The agency said denying treatment or forcing patients to pay money violates the scheme’s purpose, which is to offer cashless health services to poor and middle-class people.
Hospitals React
When asked, officials from SMHS claimed they did not deny any patient intentionally. They said that in most cases, the treatment exceeded the allowed limit or the package was already used up by the beneficiary. Still, the explanation hasn’t satisfied everyone.
Background and Previous Action
Earlier, similar notices were issued to many private hospitals in J&K. Some of them faced heavy fines and were even removed from the list of empanelled hospitals. Now, the same scrutiny is being applied to government hospitals to ensure fairness and transparency.
Government’s New Step
To strengthen public trust and improve care in government hospitals, SHA has now reserved four major surgical procedures only for public hospitals. This decision is meant to improve transparency and promote ethical medical practices.
The government has made it clear that both private and public hospitals must follow the rules of the AB-PMJAY SEHAT scheme. Patients should not suffer or be forced to pay money when they are eligible for free care. It’s a big step to make the healthcare system fairer and better for all.
FAQs
What is the AB-PMJAY SEHAT scheme?
It is a health insurance scheme providing free cashless treatment to people in Jammu and Kashmir.
Why are hospitals being sent notices?
Because they forced patients to pay out of their pockets, violating the scheme’s rules.
Which hospital received the most complaints?
SKIMS, Soura had the highest number, with 14 complaint cases.
What actions can be taken against these hospitals?
They may face penalties, suspension from the scheme, or legal action.
Has this happened with private hospitals too?
Yes, earlier private hospitals were also penalised for the same issue.
